Penetrating pulmonary vein laceration following blunt chest trauma

Shlomo Y Ishay; Lior Raichel; Limor Y Tabo; Michael Semyonov; Guy Barsky; Asaf Acker; Gad Shaked; Gideon Sahar

doi:10.1016/j.tcr.2021.100596

Penetrating pulmonary vein laceration following blunt chest trauma

Trauma Case Rep. 2021 Dec 23:37:100596. doi: 10.1016/j.tcr.2021.100596. eCollection 2022 Feb.

Authors

Shlomo Y Ishay¹, Lior Raichel¹, Limor Y Tabo¹, Michael Semyonov², Guy Barsky³, Asaf Acker⁴, Gad Shaked³, Gideon Sahar¹

Affiliations

¹ Department of cardiothoracic surgery, Soroka University Medical Center, Israel.
² Department of anesthesia, Soroka University Medical Center, Israel.
³ Department of general surgery, Soroka University Medical Center, Israel.
⁴ Department of Orthopedic Surgery, Soroka University Medical Center, Israel.

Abstract

Flail chest is a common injury in blunt trauma which is usually treated with analgesia, oxygen, and other conservative measures. In more severe cases mechanical ventilation and surgical stabilization of rib fractures (SSRF) may be warranted. Penetrating injury to the heart or great vessels due to rib fractures however, is much less common. Here we present a 33 year old male that was admitted to the Emergency department (ED) after a horse riding accident, demonstrating severe shock. Emergency computerized tomography scan showed multiple bilateral displaced rib fractures, Left hemothorax and possibly a penetrating injury to the left side of the heart by one of the ribs. Notably, no significant pericardial effusion was demonstrated. In addition, a grade V splenic injury was diagnosed. A Joined thoracic and abdominal emergent surgical treatment was successfully carried out and the patient survived and fully recovered.

Keywords: Cardiothoracic; ED, Emegency department; FAST, Focused abdominal sonogram for trauma; General surgery; Intensive care; Orthopaedics; SSRF, Surgical stabilization of rib fractures; Shock.

Publication types

Case Reports